Individual
BENJAMIN BODNAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 955-9441
Mailing address
6201 GREENLEIGH AVE, BALTIMORE, MD 21220-2004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D80379
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010051783CT01
ANTHEM BCBS CT
CT
01
—
1186694
USA
CT
05
—
1750525549
—
CT
01
—
5680912
AETNA
CT
01
—
848225
WELLCARE
CT
01
—
PENDING
RAILROAD MEDICARE
CT
Enumeration date
04/24/2009
Last updated
04/04/2023
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